Ftegistra" co,fll

CERTIFICATE OF REGISTRATION
This certiJies that:
RELAXOBAK, INC.
4956 West 300 N.
Anderson, lN 46011
is registered and has listed the following medical device with the U.S. Food and Drug Administration for FY 2016
pursuant to Title 21,807 et seq. of the United States Code of Federal Regulations:
Establishment Registration:
Device Classification Name:
Product Code:
Regulation Number:
Official Correspondent:
1616728
CUSHION, FLOTATION
KIC
890.3175
Registrar Corp
144 Research Drive, Hampton, Virginia, 23666, USA
Telephone: +l -7 57 -224-0177 . Fax: +l -7 57 -224-017 9
will confirm that such registration remains ffictive upon request and presentation of this
certiJicate until the end of the year stated above, unless said registration is terminated afier issuance of this
certificate. Registrar Corp makes no other representations or waruanties, nor does this certiJicate make any
representations or walTanties to any person or entity other than the named certificate holder,'for whose sole
beneJit it is issued. This certificate does not denote endorsement or approval of the certiJicate-holder's device or
establishment by the U.S. Food and Drug Administration. Registrar Corp assumes no liability to any person or
entity in connection with the foregoing.
Pursuant to 21 CFR 807.39, "Registration of a device establishment or assignment of a registration number does
not in any wqy denote approval of the establishment or its products. Any representation that creates an
impression of fficial approval because of registration or possession of a registration number is misleading and
c ons titut e s mi s br andin g. "
Registrar Corp
The U.S. Food and Drug Administrqtion does not issue a certificate of
Drug Administration recognize a certificate of regisnation. Registrar Co1
does
:s,
with the
U.S.
and Drug Administration.
Ftegistra"
co,fll
144 Research Drive, Hampton, Virginia, 2
Iblephonez +l-757-22.4-0177 o Fax +l-757info@registrarcorp.com . www.registrarcorp
K. Statman
Director
02005-2010 Registrar Corp